Healthcare Provider Details

I. General information

NPI: 1760982136
Provider Name (Legal Business Name): PRECIOUS K IZAH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PRECIOUS NWOKOJI

II. Dates (important events)

Enumeration Date: 02/12/2018
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3614 S COOPER ST
ARLINGTON TX
76015-3411
US

IV. Provider business mailing address

3614 S COOPER ST
ARLINGTON TX
76015-3411
US

V. Phone/Fax

Practice location:
  • Phone: 817-460-7080
  • Fax:
Mailing address:
  • Phone: 817-460-7080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95257777
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1166906
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: